| NPI | 1356634679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D79788) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD449364) |
| 207P00000X Emergency Medicine (Licence: PA MT199440) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2020-09-09 |